Outcomes Following First MTPJ Replacement Using the Roto-Glide Prosthesis

Area of Science:

• Orthopedic surgery
• Podiatric medicine
• Biomedical engineering

Background:

• Hallux rigidus is a degenerative condition of the first metatarsophalangeal joint.
• Arthrodesis (fusion) is a common treatment, but joint replacement aims to preserve motion.
• Limited data exists on the medium- to long-term efficacy of the Roto-Glide prosthesis for this condition.

Purpose of the Study:

• To prospectively evaluate the medium- to long-term functional outcomes and implant survivorship of the Roto-Glide prosthesis.
• To assess the rate of complications and explantation to fusion for patients with end-stage hallux rigidus.

Main Methods:

• Prospective study of 30 patients (35 joints) with stage 3 or 4 hallux rigidus treated with Roto-Glide prosthesis (2014-2020).
• Outcomes assessed using Manchester-Oxford Foot Questionnaire (MOXFQ) scores and weightbearing radiographs.
• Implant survivorship defined by explantation to fusion; complications and functional outcomes were recorded.

Main Results:

• Significant improvement in MOXFQ scores from baseline (47.0) to final follow-up (6.3) (P < .001).
• Mean follow-up was 95 months; implant survivorship was 89.2% at 8 years.
• Postoperative complications included stiffness (11.4%) and explantation (14.3%) due to infection, loosening, or subluxation.

Conclusions:

• Roto-Glide prosthesis provides significant medium- to long-term functional improvement for hallux rigidus.
• Implant survivorship is encouraging, but complication rates warrant attention.
• Further comparative studies are needed to establish arthroplasty as an alternative to arthrodesis.